IPT: A Promising Therapy

By: Garry Cooper, LCSW

Reprinted with permission from Psychotherapy Networker magazine. Copyright, Psychotherapy Networker, Inc.

 

For the last decade, Interpersonal Psychotherapy (IPT) has emerged in the research literature as perhaps the most effective treatment for depression. In most head-to-head studies, it has fared as well or better than cognitive-behavioral therapy, the generally recognized treatment of choice for depression. Yet relatively few therapists have heard of IPT, and those who have often confuse it with lowercase “interpersonal psychotherapy,” a generic term for psychodynamic approaches.

Part of the reason for the relative obscurity of IPT has been that its developers have taken the almost unheard of step among new therapy approaches of testing their product before marketing it. The developers of IPT, the late psychiatrist Gerald Klerman, his psychologist wife, Myrna Weissman, who is professor of psychiatry at the New York State Psychiatric Institute, and psychiatrist John Markowitz of Cornell University, have been far more interested in designing controlled research studies than traveling the workshop circuit. That has meant that, until recently, the news about IPT has mostly appeared in psychiatric journals, which aren’t the common fare of practicing therapists.

IPT, a short-term treatment of 12-16 weekly sessions, focuses on concrete, current issues in clients’ lives. The therapist quickly determines which of four areas of clients’ lives are linked to their depression: they may be mired in delayed grieving; stuck at an impasse in a relationship; slogging through a role transition, such as retirement or divorce; or laboring under some habitual interpersonal deficit, such as not being able to state feelings or desires. Grieving-delayed clients are encouraged to mourn; later they are directed toward new activities and relationships that will compensate for the loss. Clients at a relationship impasse are encouraged to quickly decide whether to end the relationship or to find a way to move it off dead center. Those in a role transition receive support in looking at the positive and negative aspects of both the new role and the old role. Clients with interpersonal deficits get help working on the missing skills, often in role play. While none of this is groundbreaking stuff, the tight focus on present social circumstances and the conceptualizing of depression into one of four problem areas serves to compress therapy into a short time span.

IPT’s time-limited treatment appeals to managed care, while its structured and manualized procedures lend themselves well to the controlled studies that journals favor. Recently, the California-based Institute of Behavioral Health, which conducts training workshops across the country, has begun an IPT certificate program. And University of Pittsburgh School of Medicine psychologists Herbert Schulberg and Paul Pilkonis published a favorable comparison study of IPT and tricyclic antidepressants in the December 1998 Journal of Consulting and Clinical Psychology.

More information on IPT is available on their website at www.interpersonalpsychotherapy.com.